Osteoarthritis and Physiotherapy

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Osteoarthritis is the most common form of arthritis, mainly affecting the knees, hands, and hips. Arthritis refers to an inflammation within a joint. Osteoarthritis on the other hand is more complex and involves inflammation and degeneration of a joint. It is usually caused by a combination of age-related changes and large increases or decreases in the use of your body that lead to pain and joint sensitivity. 

Typical changes include

  1. Degeneration of the cartilage that cover the ends of bones 
  2. Inflammation within the joint developing which can lead to swelling and pain
  3. Decreased release of the fluid that helps your joints move smoothly over one another
  4. Development of bony spurs in the later stages 

These changes within joints can lead to the following symptoms

  1. Pain and stiffness on movement
  2. Stiffness that is worst in the morning and improves through the day
  3. Limited range of movement with bending the knee or moving the hip towards the chest
  4. Pain on standing or putting weight through your joints
  5. Decreased strength of the muscles around the joint due to pain and disuse 

Solutions 

  1. NSAIDS- such as ibuprofen-this can help in the short term 
  2. Corticosteroid injections-often performed in an attempt to decrease the inflammation and pain in the joint temporarily
  3. Joint replacement surgery-performed to reduce the pain associated with joint surfaces making contact with each other
  4. Physiotherapy-active movements and pain relief treatments to improve the health of the joint and the life quality of the patient

Physiotherapy vs. Surgery 

Osteoarthritis is a complex condition, affected by how you move your body, your activity history, age, and level of fitness. Our Physiotherapy team at For Health’s Sake will work with you to determine your specific goals and needs, and build an exercise program that improves your quality of life. Physiotherapy via tailored exercises has been shown to:

  1. Improve range of motion and pain levels
  2. Increase ability to walk, climb stairs and engage in meaningful activities for patients
  3. Improve muscle strength, coordination, and balance 
  4. Exercise provides a pain reducing benefit that is maintained for up to 2 months after stopping

Food for Thought

  1. X Rays are not a good indicator of absolute prognosis as many people have degenerative changes on imaging but good strength and movement
  2. Exercise shows great effects without the need for surgery and engaging in exercise has pain reducing effects!
  3. Exercise is always trailed first before any surgery and is the best first treatment and it is never too late to start!

References 

Davis, A.M., Davis, K.D., Skou, S.T. et al. Why Is Exercise Effective in Reducing Pain in People with Osteoarthritis?. Curr Treat Options in Rheum 6, 146–159 (2020). 

Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015 Dec;49(24):1554-7. doi: 10.1136/bjsports-2015-095424. Epub 2015 Sep 24. PMID: 26405113.

What is Osteoarthritis? Osteoarthritis Research Society International 

https://oarsi.org/what-osteoarthritis

By: Elias Peixoto, Physiotherapy Resident